Exotics Adoption Application - The Moon Dog Farm

ADOPTION AGREEMENT

HOUSING AGREEMENT

LIABILITY

ADOPTION FEES

	Single	Bonded Pair
Rabbits:	$125	$150
Guinea Pigs:	$40	$75
Hamsters/Gerbils/Mice:	$10	$15

EXOTICS ADOPTION APPLICATION

First Name *(Required)

Last Name *(Required)

Date of Birth *(Required)

Date

Driver's License Number

Phone Number *(Required)

Email *(Required)

example@example.com

Address 1(Required)

Address 2

City *(Required)

State *(Required)

Zip *(Required)

If not, previous address

If rent, please provide landlord’s name and phone:

Current Occupation *(Required)

Number of Years at Current Job *(Required)

Household Information

Number of Adults in Household *(Required)

Number of Children in Household *(Required)

Ages of Children *(Required)

If yes, who

In general, how would you describe life at your house?

How long have you been looking for a pet? *(Required)

If you have had pets in the past or currently have pets, please describe (name, breed/mix, age, gender, spayed/neutered, living/deceased)*(Required)

If yes, what were the circumstances?

Under what circumstances would you, or have you, euthanized a pet?

Current Veterinarian *(Required)

Veterinarian Address *(Required)

Veterinarian Phone *(Required)

New Exotic Information

How will you handle your pet’s exercise and stimulation needs?

Please describe in detail the type of habitat you will have prepared for your pet

How many hours per day will your pet be home alone ? *(Required)

Who will be your pet’s primary caregiver? *(Required)

In case of emergency, who will care for your pet? *(Required)

What do you plan to feed your pet?

Which animal are you looking to adopt? *(Required)

Describe your expectations for the amount of time it will take your pet to adjust to your new home and what you think that will look like. *(Required)

Please provide (3) personal references (name, relationship, phone)

Reference 1

Reference 2

Reference 3

How did you hear about us? *(Required)